Getting back to business after longing for a return to pre-pandemic life was a collective feeling

A 2018 Gartner report estimates that 3% to 7% of all paid claims dollars in Payer commercial business are improperly paid.

Charles Darwin once said, “It is not the strongest of the species that survives, nor the most intelligent; it is the one most adaptable to change.”

Many companies have been unsuccessful in identifying the right data strategy that can give them sustained competitive advantage.

The COVID-19 pandemic...

Advancing into the future of payment integrity

Today's patients see digital technology as an enabler in their journey to wellness - they are always connected, and this has fundamentally changed their expectations and behaviors. Read on to know more how the technology landscape is enabling this revolution in healthcare.

Implement cloud as a tool for higher business efficencies and as a unique business proposition

When we decide to purchase a product or service, we look for its ratings or reviews.

The Medicare Open Enrollment Period, sometimes called the Annual Election Period (AEP), runs each year from October 15 to December 7.

The health ecosystem is triggering a surge in analytics. The insight from this will be pivotal for outcomes-based health.

How can Health Plan case workers comply with CMS Regulations?

Read about how Health plans can improve financial performance and health outcomes by integrating member information across the enterprise.

Medical information is representative of complex relationships which often mislead practitioners to provide a holistic and comprehensive patient guidance.Semantic Networks however,simplify the process to aggregate,organize and disseminate professional knowledge for effective diagnosis and treatments possible.

Health benefit exchanges will make affordable healthcare available in a transparent manner. They will accelerate the growth of the healthcare sector by presenting new opportunities for payors, providers and healthcare administrators.

Population Health presents an opportunity to address the outcomes at the patient and group level by assimilating patient data from disparate sources, stratifying patients based on risks, understanding adherence and compliance barriers, and coordinating care beyond the ‘four-walls’

When managed proactively, an increase in provider data quality and reduced time between data submission and use can lead to improved provider directory accuracy, more accurate claim adjudication and reimbursement, as well as greater overall member and provider engagement.

Integrated care management promises great benefits for patients, providers and payers, but requires disciplined planning and execution.

The employee healthcare benefits reckoning is here. The enduring impact of COVID-19 has converged with digital transformation – especially the accelerated advancement of data collection and analytics – to create sweeping changes in employee-employer relations. The chaotic pace of change in managing remote workforces and retaining top talent has placed an enormous strain on employers. Meeting bottom lines while addressing significant increases in employee healthcare costs and premiums can become an existential struggle.

This edition of Winsights features articles from Subject Matter Experts, key findings from reports on analytics and consumeriation by the Economist Intelligence Unit, a poll from delegates at Davos and more.